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A large Swedish study that examined prenatal exposure to prescribed opioid pain medications and the child’s risk of later developing autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) found no causal link between prescribed opioid use during pregnancy and risk of the conditions. As published in PLOS Medicine, researchers analyzed data from more than 1.2 million children for ASD (2007–2018) and more than 900,000 children for ADHD (2007–2015). By the time the subjects were 10 years old, 2.0% of unexposed children, 2.9% of those exposed to low-dose opioids, and 3.6% of those exposed to high doses of prescribed opioids had a diagnosis of ASD. Researchers found ADHD showed a similar pattern. However, after adjusting for genetic and environmental confounders, an association with prescribed opioids was not found, according to the authors.
Individualized treatment: The authors say clinical decision-making for the treatment of pain during pregnancy must weigh the risks and benefits. They believe the causal effect of moderate prescription opioid use during pregnancy on ASD and ADHD may be minimal based on the converging results of their multiple quasi-experimental designs.